New Dealer Account Activation Form Please enable JavaScript in your browser to complete this form.Activation Date *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Company Information Company Name *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeWebsite / URLPhone Number *Fax PhoneShowroom LocationClick here if the showroom address is different form the business addressShowroom AddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeWarehouse Location Click here if the warehouse address is different form the showroom addressWarehouse AddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeIs the showroom accessible by semi-truck?YesNoIs the warehouse/shop accessible by semi-truck?YesNoReceiving hours for Semi-TruckWill they require to have orders palletized?YesNoWho needs to receive delivery list?Accepts UPS deliveries?YesNoIs there a different address for UPS deliveries?YesNoProvide additional address for UPS deliveries:Address Line 1Address Line 2CityState / Province / RegionPostal CodeDoes this dealer have multiple locations? YesNoIf yes, please submit this form again for each location. For this location, please confirm shipping address and hours for Semi-truck and UPS deliveries.Contact InformationPlease include each business contact in a new line Contact Name *Contact Position (State if they are designer, designer assistant, design manager and note if they should have access to DPP and Account Receivable Reports) *Please list how you would like them set up in DSSContact Email Address *Contact Phone *Account Set UpEmail Address for Invoices *Private Labels *AlluraCynergiBurton AllenDreamroomsFinaSorrentoTaloraZonavitaDoor BuilderYesNoDecor Branded MultiplierZonavita MultiplierDecor Dealer Type *A-FRIA-FRIA-THUA-WEDA-TUEB-FRIB-THUB-WEDB-TUEC-FRIC-THUC-WEDC-TUED-THUD-WEDD-TUEE-THUE-WEDZonavita Dealer Type *AABCDDealer Development Specialist *Bev McGillBev McGillBonnie PennerMick PayneRodney HicksSteve FriesenCustomer Solutions Representative *Austin PennerAustin PennerCarlos BartschCraig GeakeImran BahadurJake Blatz Luisa BlockMonica RodriguezPaul HarringtonPauline Buhler Ruth HiebertSalena WaldnerVanessa PopeVicki FilzWhat design software is used?Industry experienceExpected account sizeUpload Door Sample List (22 total) Click or drag a file to this area to upload. Accepted file types: .pdf, .png, .gif, .jpg, .doc, .docx, .xlsx, .xlsm, .xlsDealer Agreement Click or drag a file to this area to upload. Accepted file types: .pdf, .png, .gif, .jpg, .doc, .docx, .xlsx, .xlsm, .xlsDiscount Agreement for StartupsAdditional NotesCommentSend New Dealer Activation Notification
